Most States Shun Fed HIX Partnerships, But Seek Accommodations

By most accounts seven is considered to be a lucky number. How that luck will play out among the seven states who have decided to partner with the federal government on running health insurance exchanges remains to be seen.

Friday was the deadline for states to decide whether or not to partner with the feds on exchanges; the seven who decided to do so include:

As unlikely as it may have seemed to the feds in the early planning stages of health insurance exchanges, a federally run exchange is what most states—27—will use. Sixteen states plus the District of Columbia will take on the job of implementing and running exchanges themselves.

"We thought there would be nearly 50 state exchanges," says Caroline Pearson, vice president for Avalere Health, "At the time, the thought of a federal exchange was considered to be really an outlier and truly a fallback, not the majority as it looks like the case will be."